Podiatrists For The Hand

A brief email interchange with one of our readers – my mom – led me to a burning question. Why isn’t there a medical specialty for the hand? Feet have their own docs – podiatrists. And hands seem to get almost as much hard use as the ol’ dogs. What goes wrong with the hand, you say? There’s arthritis, carpal tunnel (which is certainly within the metro area, if not in the hand per se), and a host of minor catastophes when fingers show up where they oughtn’t be. Perhaps there are good medical or market reasons for this gaping hole in the medical service field. But if not, perhaps now is time for President Bush to issue a national call. Forget engineers. Forget chemists. Forget ethnomusicologists. (Oops, I think we already have.) Podiatrists for the hand, I say!

Which reminds me. If you’re going to be in NYC this weekend, let me commend to you an amazingly bizarre and fun pair of one-acts, Americana Absurdum, playing at the Lucille Lortel Theater as part of the NY Fringe Festival. The plays, written by Brian Parks, feature an odd character who sells “foot powder for the head.” Perhaps he’s on to something there.

13 Responses

Well, podiatrists aren’t medical doctors, so calling podiatry a “medical specialty” is a bit misleading. I guess your question goes more to, “Why, of all the idiosyncratic areas of the body to choose, is there a separate school for the feet?” For which I don’t have an answer. But if I really had a major foot problem, I still wouldn’t go to a podiatrist; I’d go see an internist and then an orthopedic surgeon — just as I would for a major hand problem.

Blah, I’m not certain that your view of podiatrists is universally accepted. In many jurisdictions, podiatrists can write prescriptions and do surgery. They are doctors of podiatry. And they often do residencies. So while MD’s probably don’t think of them as doctors (and many deny that OD’s are docs as well), that perspective may have more to do with guild protection than legal or cultural status.

This is a horrible representation of podiatrists. They are not “foot technicians” this is wildly inappropriate. Podiatrists take all the same classes as MD and DO students in medical school. They dissect an entire body, and learn the anatomy and physiology of the whole body because it is impossible to only treat a part of the body without focusing on the whole person. All podiatrists are able to be board certified surgeons, include a lot of difficult cases. Actually, it would be smarter to go to a podiatrist than an orthopod because podiatrists study feet/lower extremity specifically from day 1 of medical school rather than specializing 6 years later. There was just a law passed in Congress under Medicare that podiatrists are able to perform their own H&P and are under “physician”. Podiatrists are physicians because of their education and training, not because they take the MCAT’s.

Some interesting comments I’ve read. Those who do not think a podiatrist is a “doctor” are either blatantly ignorant or just misinformed. A podiatrist, upon graduation of 4 years of podiatric medical school, is granted DPM or doctor of podiatric medicine. Then, we are required to do a three-year residency in which we perform rounds through all specialties of medicine. A podiatrists’ training is very similar to any MD or DO program in the country. The big difference is that we diverge and focus on the lower extremity. A podiatrists’ training today is held to a much higher standard than it was even 10 years ago. All podiatry schools do require the MCAT for entrance, and the boards are almost identical to those of MD’s. Surgical training for a podiatrist is very thorough and extensive through the three-year and even four-year residency programs. Orthopedist are usually very aware of the importance of podiatrists in treating lower extremity problems. Of course there are those who want to do it and think they can, but if they haven’t had the training that a podiatrist has had, they shouldn’t perform the procedure. Podiatrists bill through Medicare just as an MD would. Podiatrists are accepted on almost all major and minor health care plans, and podiatrists do perform full histories and physicals and admit to hospitals. I believe in educating yourself about a profession before posting and making yourself look like a fool (Ron Wegner). And for (blah), I’d like to see what your internist has to say about a Lifranc’s fracture. Ask him/her and let me know.

Your answer blah: 66% of Americans are overweight and of that, 33% are obese. This equates in to millions of people with diabetes. Millions others have diabetes for other reasons. Diabetes severely manifests itself in the lower extremities. Podiatrists are trained to diagnose and treat such problems. This is only one reason there are podiatrists. Do your hands support the weight of your entire body? Do you develop “fallen hands” and require hand orthotics? Podiatry is a critical field of medicine for numerous reasons. I suggest you do a little reading of your own, educate yourself, inform yourself about the field, then talk to a few podiatrists. And for Dan Filler, there are hand specialists. Orthopedic surgeons can specialize in the hand if they’d like. They have to pass the exams to do it, but they can do it.

If podiatrists can perform full body H&Ps, then this means podiatrists can diagnose full body just like the MD or DO.

Podiatrists can diagnose full body.

But they only treat and prescribe medically below the knee, and surgically either a) below the knee b) whole foot but not ankle, c) foot and ankle but not tibia and fibula, or d) forefoot only (dig-met)

A podiatrist can use a stethoscope, a tuning fork, a penlight, an otoscope, opthalmoscope,reflex hammer, and sphygmomanometer with blood pressure cuff just like the MD physician on the head, neck, thorax, upper extremities, abdomen, back, pelvis, and perineum for diagnostic purposes only. And order blood tests and imaging tests full body. Great!

People are so ignorant about the field of podiatry. Let me remind some of you that at some big trauma hospitals, all lower extremity cases go to podiatry first. Ortho residents need permission to scrub in on some of the foot/ankle procedures. DMC in Detroit and Oakwood in Dearborn,Michigan take all lower extremity cases.